Back to Search
Start Over
Early menopause is associated with lack of response to antiviral therapy in women with chronic hepatitis C.
- Source :
-
Gastroenterology [Gastroenterology] 2011 Mar; Vol. 140 (3), pp. 818-29. Date of Electronic Publication: 2010 Dec 16. - Publication Year :
- 2011
-
Abstract
- Background & Aims: Chronic hepatitis C (CHC) and liver fibrosis progress more rapidly in men and menopausal women than in women of reproductive age. We investigated the associations among menopause, sustained virologic response (SVR), and liver damage in patients with CHC.<br />Methods: We performed a prospective study of 1000 consecutive, treatment-naïve patients 18 years of age and older with compensated liver disease from CHC. Liver biopsy samples were analyzed (for fibrosis, inflammation, and steatosis) before patients received standard antiviral therapy. From women (n = 442), we collected data on the presence, type, and timing of menopause; associated hormone and metabolic features; serum levels of interleukin-6; and hepatic tumor necrosis factor (TNF)-α.<br />Results: Postmenopausal women achieved SVRs less frequently than women of reproductive age (46.0% vs 67.5%; P < .0001) but as frequently as men (51.1%; P = .283). By multivariate regression analysis, independent significant predictors for women to not achieve an SVR were early menopause (odds ratio [OR], 8.055; 95% confidence interval [CI], 1.834-25.350), levels of γ-glutamyl transpeptidase (OR, 2.165; 95% CI, 1.364-3.436), infection with hepatitis C virus genotype 1 or 4 (OR, 3.861; 95% CI, 2.433-6.134), and cholesterol levels (OR, 0.985; 95% CI, 0.971-0.998). Early menopause was the only independent factor that predicted lack of an SVR among women with genotype 1 hepatitis C virus infection (OR, 3.933; 95% CI, 1.274-12.142). Baseline levels of liver inflammation, fibrosis, steatosis, serum interleukin-6 (P = .04), and hepatic TNF-α (P = .007) were significantly higher among postmenopausal women than women of reproductive age.<br />Conclusions: Among women with CHC, early menopause was associated with a low likelihood of SVR, probably because of inflammatory factors that change at menopause.<br /> (Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Age Factors
Biomarkers metabolism
Biopsy
Female
Genotype
Hepacivirus genetics
Hepatitis C, Chronic complications
Hepatitis C, Chronic diagnosis
Hepatitis C, Chronic immunology
Humans
Immunohistochemistry
Inflammation Mediators metabolism
Interleukin-6 blood
Italy
Liver Cirrhosis diagnosis
Liver Cirrhosis virology
Logistic Models
Male
Middle Aged
Odds Ratio
Prospective Studies
RNA, Viral blood
Risk Assessment
Risk Factors
Severity of Illness Index
Sex Factors
Time Factors
Treatment Failure
Tumor Necrosis Factor-alpha metabolism
Viral Load
Antiviral Agents therapeutic use
Hepatitis C, Chronic drug therapy
Menopause, Premature immunology
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0012
- Volume :
- 140
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 21167831
- Full Text :
- https://doi.org/10.1053/j.gastro.2010.12.027